RPN Safe Medication Administration 3 — Questions and Answers
Question 1: Which route of administration provides the fastest onset of action in an emergency situation?
- Intramuscular
- Subcutaneous
- Intravenous (Correct answer)
- Sublingual
Correct answer: Intravenous
Intravenous administration delivers medication directly into the bloodstream, producing the fastest onset of action.
Question 2: A nurse is about to administer morphine 4 mg IV. The patient's respiratory rate is 10 breaths per minute. What should the nurse do?
- Administer the full dose as ordered
- Administer half the dose and reassess
- Hold the medication and notify the prescriber (Correct answer)
- Administer the dose slowly over 10 minutes
Correct answer: Hold the medication and notify the prescriber
A respiratory rate below 12 is a contraindication to opioid administration; the nurse must withhold the dose and contact the prescriber.
Question 3: When reconstituting a powdered medication, what should the nurse do immediately after adding diluent?
- Draw up the solution before mixing is complete
- Shake the vial vigorously to dissolve quickly
- Roll the vial gently between the palms and inspect for complete dissolution (Correct answer)
- Refrigerate the vial for 10 minutes before use
Correct answer: Roll the vial gently between the palms and inspect for complete dissolution
Gently rolling ensures complete dissolution without creating excessive bubbles, and visual inspection confirms the solution is clear before use.
Question 4: A patient with a documented penicillin allergy is prescribed amoxicillin. What is the nurse's priority action?
- Administer the drug since it is a prescribed order
- Give a test dose first and monitor for 30 minutes
- Withhold the medication and clarify the order with the prescriber (Correct answer)
- Ask the patient if they have had amoxicillin before
Correct answer: Withhold the medication and clarify the order with the prescriber
Amoxicillin is a penicillin-class antibiotic; administering it to a patient with a documented penicillin allergy is unsafe and requires prescriber clarification.
Question 5: Which statement about the administration of enteric-coated tablets is correct?
- They may be crushed if the patient has difficulty swallowing
- They must be swallowed whole to protect the stomach lining (Correct answer)
- They can be opened and dissolved in water for NG tube administration
- They should be taken with antacids to enhance absorption
Correct answer: They must be swallowed whole to protect the stomach lining
Enteric-coated tablets must not be crushed or chewed because the coating protects the stomach or ensures the drug releases in the intestine.
Question 6: The RPN is administering an eye drop to a patient. Which technique is correct?
- Place the drop directly on the cornea for fastest absorption
- Pull down the lower eyelid to create a conjunctival sac and instill the drop (Correct answer)
- Ask the patient to blink rapidly after instillation
- Wipe excess medication toward the inner canthus
Correct answer: Pull down the lower eyelid to create a conjunctival sac and instill the drop
Instilling drops into the conjunctival sac avoids corneal irritation and allows proper absorption of the medication.
Question 7: A high-alert medication label on a medication indicates that the nurse should:
- Administer the medication without additional checks to save time
- Obtain an independent double-check from another nurse before administration (Correct answer)
- Dilute the medication more than usual
- Document administration only after the full dose is given
Correct answer: Obtain an independent double-check from another nurse before administration
High-alert medications require an independent double-check by a second licensed nurse to reduce the risk of serious patient harm.
RPN Safe Medication Administration 3
Which route of administration provides the fastest onset of action in an emergency situation?